Healthcare Provider Details

I. General information

NPI: 1124486568
Provider Name (Legal Business Name): MARCUS STEVEN ANGULO N.P
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2016
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8970 WARNER AVE
FOUNTAIN VALLEY CA
92708-3211
US

IV. Provider business mailing address

1190 BAKER ST #100
COSTA MESA CA
92626-4108
US

V. Phone/Fax

Practice location:
  • Phone: 714-477-8400
  • Fax: 714-477-8401
Mailing address:
  • Phone: 949-791-3250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-2076
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95003536
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: